Aetna - appeals committee
I have been denied by Aetna for VSG. First because they stated I didn't meet the criteria of weightloss. However, I appealed and proved that I do meed the medical criteria however, they came back with a second denial because they say that I didn't meet psych clearance. Which was untrue. I faxed in the pysch clearance but now they want to do a Level II appeal committee tele - conference. I can choose to phone in and state my case to an unknown board I will be given 15 minutes to do this. Then I will be asked to leave the call where they will deliberate without me and send me a letter with their decision within 5 business days. They also state that I can have a lawyer present it I want to. WTF. Does anybody have any experience with this? What should I expect?